Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

taz- year 3 med > infectious diseases > Flashcards

infectious diseases Flashcards

1
Q

what are some common bacteria that can cause soft tissue/skin infections

A

Staphylococci – Staph. aureus

Streptococci (e.g. Group A Strep)

MRSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what abx would you use for a staph or a strep skin infection? what would you use if you had an allergy

A

Staphylococci- Flucloxacillin

Streptococci- Benzylpenicillin / Fluclox

If Penicillin allergy:

  • Tetracycline (doxycycline)
  • Carbapenem(eg meropenem)
  • Cephalosporin(eg ceftriaxone)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what abx would you use for a MRSA skin infection

A

Glycopeptide (eg vancomycin, teicoplanin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are some common respiartory disease causing bacteria and what abx would you use for them

A

Streptococci (S. pneumoniae)- Penicillin (Amoxicillin) Macrolide (eg erythromycin, clarithromycin)

H. influenzae- Co-amoxiclav (amox + clavulinic acid)

“Atypical” (Legionella, Mycoplasma)- Doxycycline Fluroquinolone/FQ (eg levofloxacin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what abx do you use for Salmonella spp. (S. typhi /paratyphi)

A

Ceftriaxone/azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what abx do you use for C. difficile

A

PO Metronidazole/Vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what abx would you use for Visceral infection/peritonitis (Usually Enterobacteriacae)

and how would you add aerobic cover

what would you give if there was a penicillin allergy

A

Co-amox OR cipro OR aminoglycoside (eg gentamicin)

Metronidazole / Co-amox
for Anaerobic cover

Carbapenem If severe infection / penicillin allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what abx would you use for Gonorrhoea (N. gonorrhoea)

A

IM/IV Ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what abx would you use for Chlamydia trachomatis

A

Azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what abx would you use for Neisseria (N. meningitidis)

A

Ceftriaxone/Cefotaxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what medication would you use for Herpes simplex virus (encephalitis)

A

IV Aciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are some common conditions for fever in returning travellers

A

malaria, dengue fever, and typhoid (enteric) fever.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how would you investigate fever in returning travellers

A
  • Exclude malaria in all travelers from the tropics
  • Exclude HIV in all
  • Most travellers have self limiting illnesses that could have been acquired in the UK. Look for tropical infection but font forget your usual differentials.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what differentials should you consider for fever in returning travlers in these time frames

  • 0-10d:
  • 10-21d:
  • > 21d:
A

0-10d: Dengue, rickettsia, viral (incl infectious mononucleosis), gastrointestinal (bacterial/amoebea)

10-21d: Malaria, typhoid, primary HIV infection

> 21d: Malaria, chronic bacterial infections (eg brucellosis, Coxiella, endocarditis, bone and joint infections); TB, parasitic infections (helminths/ Protozoa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is a fever in returning trailer till proven otherwise

A

Malaria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how is malaria spread

A

Transmission occurs through the bit of an infected Anopheles mosquito. Only female mosquitoes transmit Plasmodium as only females require a blood meal for egg development. Transmission in the absence if a mosquito is rare; vertical (congenital transfer from mother to child), transfusion, rogan transplantation, needle sharing.
• P. Falciparum results in the most serious illness. Approx 90% of malaria cases originate in africa. Other common species: P.vivax, P.ovale (most SE Asia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the clinical features of malaria

A

consider in anyone with a fever which has previously visited a malarial area.
• presentation: abrupt onset of rigours followed by high fevers, malaise, severe headache and myalgia, vague abdominal pain, nausea and vomiting, diarrhoea may occur in up to 25% of pt.
• Examination: fever, otherwise unremarkable. If diagnosis is delayed or severe disease then may present with jaundice, confusion, seizures, pallor due to anaemia and hepatosplenomegaly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how does malaria present

A
  • travel history to area of high humidity, rural location, cheap accom, outdoors at night roughly 2 weeks ago
  • non specific symptoms: fever, chills, headaches, cough, myalgia, GI upset
  • signs: hepatomegaly, jaundice, abdo tenderness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are features of late/ severe malaria?

A

Impaired consciousness, SOB, bleeding, fits, hypovolaemia, hypoglycaemia, AKI, resp distress syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the 3 causative organisms of malaria and what are their incubations?

A

Plasmodium falciparum: 7-14 days (most common in africa)
Plasmodium vivax: 12-17 days w/ relapses common due to dormant parasites in liver
Plasmodium ovale: 15-18 days, also relapsing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How should suspected malaria be investigated?

A
  • 3x thick and thin blood films with giemsa stain
  • rapid antigen test
  • FBC, U&E, LFT, G6PD activity (prior to giving primaquine), blood glucose, gases, clotting, lactate (if severe)
  • head CT
  • CXR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How is p. falciparum treated?

A

IV quinine initially (needs ECG monitoring) then oral quinine and doxy for 7 days when they can swallow.
Supportive treatment also

Sulphate and Doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How is p vivax and ovale malaria treated?

A

Cholorquine (3-4 days) and primaquine (14 days)

Supportive treatment also

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are some complications of malaria

A
  • Disseminated Intravascular Coagulation
  • Cerebral malaria confusion, fits, coma
  • ARDS
  • Blackwater Fever (IV Haemolysis dark urine) -> Renal failure + Lactic acidosis
  • Hypoglycaemia (<2.2)
  • Shock – rarely occurs in malaria (‘Algid Malaria’) should prompt suspicion of concurrent sepsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

how is Typhoid fever (also known as enteric fever) transmitted

A

Typhoid fever is a potentially fatal multisystem illness caused primary by Salmonella typhi and paratyphi. It is transmitted by the faecal-oral route.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How does typhoid present? What is the relevance of their tongue?

A

Gradually increasing fever, malaise, headache, dry cough, abdo pain, diarrhoea, furred tongue with red edges and tip, bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What organism causes thyphoid, what is incubation period and how does it spread?

A

Salmonella typhi
Incubation period is 10-20 days for S typhi and 1-10 days for S paratyphi
Spreads through contaminated water and food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How is typhoid investigated?

A
  • Blood cultures (gram neg bacillus)
  • FBC, U&E, LFT
  • blood films for malaria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How is typhoid managed? (4)

A
  • IV ceftriaxone or azithromycin
  • steroids in severe disease
  • supportive
  • side room, PPE, careful handwashing and faeces disposal
  • surgery if bowl perforates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Give 3 signs characteristic of Typhoid Fever

A

Faget’s Sign (Bradycardia and Fever)
Rose Spots
Hepatosplenomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Define Pyrexia of Unknown Origin

A

Temperature more than 38 degrees on more than one occasion
Illness>3 weeks duration
No diagnosis despite 1 weeks worth of inpatient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Categories of causes of PUO include Infective/Autoimmune/Neoplastic and Other. Give 2 examples of each.

A

Infective - TB, Brucellosis (slow growing)
Autoimmune - Temporal Arteritis, Wegener’s Granulomatosis
Neoplastic - Leukaemia, Lymphoma
Other - Thromboembolism, Hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How is TB spread?

A

Aerosol inhalation causing pulmonary infection and subsequent haematogenous spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the Quantiferon test?

A

Assesses the amount of interferon gamma released from T cells when exposed to mycobacterium
CANNOT differentiate between active and latent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the T Spot test?

A

Same principle as Quantiferon test but tests an individual T lymphocyte (good for immunosupressed patients)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How is latent TB treated?

A

Not treated if over 35 usually (high risk of hepatotoxicity)

3 months Rifampicin and Isoniazid OR 6 months isoniazid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Give 4 symptoms of active TB

A

Non resolving cough
Weight loss
Night sweats
Haemoptysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Describe 3 features seen on a TB XRay

A

Mediastinal lymphadenopathy
Cavitating Pneumonia
Pleural Effusion

39
Q

What would be seen on a CT scan of TB?

A

Lymphadenopathy (often with central necrosis)

40
Q

How would you aim to take a biopsy from a suspected pulmonary TB patient?

A

FIrst try a sputum sample
If the sputum sample is negative then proceed to bronchoscopy/EBUS to take sample from pulmonary lymph nodes (caseating granulomatous inflammation)

41
Q

What would you see on the lumbar puncture of meningeal TB?

A

Inreased lymphocytes
HIGH protein
Low glucose

42
Q

What is the paradoxical reaction in TB?

A

As bacteria die there is an increase in inflammation causing worsening symptoms
Steroids are initiated if this is in a place where an increase in inflammation would not be tolerable (eg CNS)

43
Q

Describe the treatment plan for Active TB

A

2 months of Rifampicin/Isoniazid/Pyrazinamide/Ethabutol along with Pyridoxine
4 months of Rifampicin/Isoniazid plus Pyridoxine

44
Q

Name 2 side effects of Rifampicin

A

Orange Urine

Drug induced hepatitis

45
Q

Name 3 side effects of Isoniazid

A

Peripheral Neuropathy (vit B deficiency)
Colour Blindness
Drug induced hepatitis

46
Q

Name a side effect of Pyrazinamide

A

Drug induced hepatitis

47
Q

Name a side effect of Ethambutol

A

Reduced visual acuity

48
Q

Give three features of infection control in TB

A

Contact tracing
Nursed in a side room until they’ve had atleast two weeks of treatment
Wear a mask if giving aerosol treatment such as nebuliser

49
Q

What extra is needed to treat TB if there is pericardial, meningeal or spinal involvement?

A

steroids- the start of the anti TB meds will cause bacteria death and inflammation which will be bad in these places

50
Q

How should suspected HIV be investigated?

A
  • HIV test (antigen and antibody testing, positive a few weeks after infection and get results on same day)
  • CD4 count
  • HIV viral load (PCR)
  • HIV resistance profile
  • syphillis and hep abc serology
  • routine bloods
  • taxoplasma, measles, varicella and rubellla IgG
  • TB cultures often
51
Q

Name 4 conditions and infections associated with severe HIV infection?

A
  • kaposi sarcome
  • TB
  • PCP (pneumocystis jiroveci pneumonia)
  • taxoplasmosis
  • CMV
  • lymphoma
  • herpes
  • candida
  • cryptococcal meningitis
52
Q

How is HIV managed?

A

Nucleoside receptor transcriptase inhibitor x2 (tenofovir, lamivudine)
+
non NRTI
or
protease inhibitor
or
integrase inihbitor
or
CCR5 (entry) inhibitor
AND hep B, pneumococcal and flu vaccines AND co trimoxazole for PCP prophylaxis if your CD4 is <200 AND opthalmology assesment for CMV retinitis if your CD4 count is <50
Also education about condoms etc is important

53
Q

Describe the pathophysiology of HIV in four steps

A

1) HIV binds to CD4 receptors on T cells
2) HIV uses reverse transcriptase to bind to host DNA
3) DNA replication
4) Causes inflammation and spreads to other tissues

54
Q

How is HIV transmitted

A

bodily fluids

55
Q

Give 5 symptoms of primary HIV

A 
Flu like
Maculopapular Rash 
Myalgia 
Lymphadenopathy 
Weight Loss
56
Q

Describe the 5 stages of HIV in terms of CD4

A 
Primary - Normal CD4
Stage 1 - >500 CD4 
Stage 2 - <500 CD4 
Stage 3 - <350 CD4 
Stage 4 - <200 CD4 (AIDs Defining)
57
Q

How is meningitis investigated?

A
  • lumbar puncture if no signs of raised ICP (ZN stain, cytology, virology, glucose, protein, culture PCR)
  • FBC, CRP, coag, culture, glucose, gases, U&E, lactate, meningococcal and pneumococcal PCR
  • throat swabs
  • sometimes a CT scan
58
Q

How is meningitis without signs of shock, severe sepsis or signs suggesting brain shift managed?

A
  • dexamethoasone 10mg IV
  • ceftriaxone IV
  • careful fluid restriction
  • Follow SEPSIS6
59
Q

What signs suggest raised ICP and so you should delay Lumbar puncture in meningitis?

A
  • severe sepsis or rapidly evolving rash
  • severe resp/ cardiac compromise
  • focal neurological signs
  • papillodema
  • continuous or uncontrollable seizures
  • GCS<13
60
Q

List 5 potential complications of meningitis

A

septic shock, DIC, septic arthritis, haemolytic anaemia, pericardial effusion, subdural effusion, SIADH, seizures, hearing loss, cranial nerve dysfunction

61
Q

Describe the pathophysiology of Meningitis

A

Inflammation of the leptomeninges (arachnoid and pia) by virus/bacteria/non infective causes

62
Q

Give four risk factors for Meningitis

A

Young Age
Immunosupression
Crowding
Spinal Procedures

63
Q

Name the causative organisms of bacterial meningitis in neonates

A

Group B Strep

E.Coli

64
Q

Name the causative organisms of bacterial meningitis in adults

A

Haemophilus Influenza
Strep Pneumoniae
Neisseria Meningitidis

65
Q

Name the causative organisms of bacterial meningitis in the elderly

A

Strep Pneumoniae

66
Q

What is Aseptic Meningitis? Give 4 examples

A

When no bacteria can be cultured

Viral Infections, Fungal Infections, TB, Partially treated meningitis

67
Q

Give 4 causes of non infective Meningitis

A

Malignant Cells (Leukaemias, Lymphomas)
Medication (NSAIDs, Trimethoprim)
Sarcoidosis
SLE

68
Q

Give 5 symptoms of Meningitis

A 
Fever
Nausea 
Headache 
Nuchal Rigidity 
Photophobia
69
Q

Describe the management of viral Meningitis

A

Supportive

IV Aciclovir if Herpes Simplex Virus is suspected

70
Q

Describe the management of bacterial Meningitis

A

Supportive

IV Ceftriaxone AND Dexamethasone

71
Q

How does dengue fever present?

A
  • abrupt onset high fever, severe headache behind eyes, myalgia, N+V, abdo pain
  • macropapular blanching trunchal rash
  • signs of bleeding, organ failure, hypovolaemia in severe disease
72
Q

What countries is dengue common in and how long is the incubation period?

A

africa/ thailand/ americas
4-10 day incubation
carried by day biting mosquito

73
Q

How is dengue investigated?

A
  • FBC (high PCV, low platelets, leukopenia), clotting studies (prolongs APTT and PT), U&Es, LFTs
  • Serum IgM and IgG antibody detection by ELISA
  • CXR if pleural effusion suspected
  • blood cultures
  • malaria film
74
Q

How is dengue managed?

A
  • All supportive:
  • Fever control w/ paracetamol/ tepid sponge/ fans
  • Iv fluid resus and fluid balance monitoring
  • haemorrhage and shock require FFP, platelets and sometimes infusion
  • severe dengue may need ITU
75
Q

Hep A is an RNA virus, how is it spread? What is the incubation period?

A

Faecal - Oral spread or by shellfish

Incubation period is 2-6 weeks

76
Q

Name four risk factors for Hepatitis

A

Personal contact
IVDU
MSM
Health workers

77
Q

Give 5 symptoms of Hepatitis A

A 
Nausea
Malaise 
Arthralgia 
Jaundice 
Pale Stools/Dark Urine
78
Q

What investigations would you do for Hepatitis A, and what would they show?

A

Immunoglobulins (raised IgG for acute infection)
LFTs (ALT raised, potential damage to synthetic function)
USS to exclude other diagnoses

79
Q

How is Hepatitis A managed?

A 
Supportive
Avoid alcohol 
Vaccine available (works for one year or twenty with booster)
80
Q

Hep B is a DNA virus, how is it spread? What is it’s incubation period?

A

Spread by blood products, sexual contact or vertically

Incubation is 1-6 months

81
Q

Give 6 symptoms of Hep B

A 
Nausea
Malaise 
Arthralgia 
Urticaria 
Jaundice 
RUQ Ache
82
Q

Describe the following Hep B Serology: HbsAg, HbeAg, Antibodies to core antigen, Antibodies to surface antigen

A

HbsAg - present 1-6 months after exposure (if persists past 6 months then it is chronic)
HbeAg - present 1.5-3 months after exposure (implies high infectivity)
Antibodies to core antigen imply past infection
Antibodies to surface antigen imply vaccination

83
Q

Describe the management of Hep B

A

Supportive
Immunise sexual contacts
Any signs of chronic liver inflammation - 48/52 of retrovirals such as Peginterferon Alfa-2a

84
Q

State two complications of Hep B

A

Cirrhosis

Hepatocellular Carcinoma

85
Q

Hep C is a RNA virus, how is it spread? What is its incubation period?

A

Spread is via IVDU, Blood Transfusions and Sexual

Incubation is 6-9 weeks

86
Q

How would acute Hep C present?

A

Often asymptomatic, may just be jaundiced

87
Q

How would chronic Hep C present?

A

Over 80% of cases are chronic

Malaise, Weakness, Anorexia

88
Q

Name three possible investigations for Hep C

A

LFTs
PCR of the virus to confirm ongoing infectivity
If PCR +ve then do a liver biopsy to assess damage

89
Q

Describe the management of Hep C

A

Stop alcohol/smoking
Start anti-virals
NO VACCINE AVAILABLE

90
Q

What is Hep D?

A

A co - infection for Hep B (as it is an incomplete RNA virus)

91
Q

How would you investigate Hep D?

A

You would test for Anti Hep B antibody, and then if that was positive, proceed to do the Anti Hep D antibody

92
Q

How would you manage Hep D?

A

Peginterferon Alfa-2a has limited success so a liver transplant may be required

93
Q

Describe three features of Hep E’s pathophysiology/epidemiology

A

RNA virus similar to Hep A
Common in Indochina
Associated with pigs

taz- year 3 med (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions